Central Centrifugal Cicatricial Alopecia and the Impact of Wig Prosthesis on Patient Quality of Life: A Case Report With Medical Insurance Appeal Letter

The document presents a case study of a 70-year-old female patient with central centrifugal cicatricial alopecia (CCCA), a permanent, irreversible scarring alopecia that negatively impacts quality of life. The patient experienced improved mood and quality of life after using a high-quality hair prosthesis (wig), as measured by the PHQ-9 and Skindex-29 scoring systems. Her PHQ-9 score improved from 6 (mild depression) to 1 (minimal depression), and her Skindex-29 score improved from 51 to 21 in the emotions category and 40 to 13 in the functioning category. However, the cost of quality wigs, which can range from $800 to $3,000, is often not covered by medical insurance. The authors advocate for insurance coverage of hair prostheses and provide a sample insurance appeal letter for this purpose.